Scholarlink

Background <p>Achieving optimal surgical margins is critical in breast-conserving surgery (BCS) to reduce local recurrence (LR) and the need for re-excision. This meta-analysis evaluated the impact of intraoperative margin optimization strategies on key surgical and oncologic outcomes in patients who underwent BCS.</p> Methods <p>A systematic review and meta-analysis were conducted according to the PRISMA guidelines, including six randomized controlled trials (RCTs). The outcomes assessed included the re-excision rate (primary outcome), positive margin rate, local recurrence (LR), and overall survival (OS). The risk of bias was evaluated using the ROB 2 tool, and the certainty of evidence was assessed using GRADE. The study protocol was prospectively registered in the PROSPERO database (<a href="https://www.crd.york.ac.uk/PROSPERO/view/CRD420251000564">CRD420251000564</a>).</p> Results <p>Intraoperative margin optimization significantly reduced re-excision rates (OR 0.54, 95% CI 0.32–0.90), corresponding to 169 fewer re-excisions per 1,000 patients. Positive margin rates were also significantly lower (OR 0.40, 95% CI 0.22–0.73), translating to 139 fewer positive margins per 1,000 patients. No statistically significant differences were observed for LR (OR 0.72, 95% CI, 0.16–3.19) or OS (OR 0.87, 95% CI, 0.73–1.03).</p> Conclusion <p>Intraoperative margin optimization effectively reduces positive margins and re-excisions in BCS without adversely affecting LR or OS. The incorporation of these strategies should be considered a standard practice to enhance surgical quality and patient outcomes.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Impact of intraoperative margin optimization strategies compared to standard breast-conserving surgery on oncologic outcomes: a systematic review and meta-analysis of randomized and prospective trials

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年8月27日

查看全文
  • Wajahat Mirza,
  • Muhammad Moaz,
  • Muhammad Sajeel Turab,
  • Hadi Mohammad Khan,
  • Sundus Dadan,
  • Saeeda Yasmin,
  • Abdullah Khan Tareen,
  • Hamza Hanif

摘要

Background

Achieving optimal surgical margins is critical in breast-conserving surgery (BCS) to reduce local recurrence (LR) and the need for re-excision. This meta-analysis evaluated the impact of intraoperative margin optimization strategies on key surgical and oncologic outcomes in patients who underwent BCS.

Methods

A systematic review and meta-analysis were conducted according to the PRISMA guidelines, including six randomized controlled trials (RCTs). The outcomes assessed included the re-excision rate (primary outcome), positive margin rate, local recurrence (LR), and overall survival (OS). The risk of bias was evaluated using the ROB 2 tool, and the certainty of evidence was assessed using GRADE. The study protocol was prospectively registered in the PROSPERO database (CRD420251000564).

Results

Intraoperative margin optimization significantly reduced re-excision rates (OR 0.54, 95% CI 0.32–0.90), corresponding to 169 fewer re-excisions per 1,000 patients. Positive margin rates were also significantly lower (OR 0.40, 95% CI 0.22–0.73), translating to 139 fewer positive margins per 1,000 patients. No statistically significant differences were observed for LR (OR 0.72, 95% CI, 0.16–3.19) or OS (OR 0.87, 95% CI, 0.73–1.03).

Conclusion

Intraoperative margin optimization effectively reduces positive margins and re-excisions in BCS without adversely affecting LR or OS. The incorporation of these strategies should be considered a standard practice to enhance surgical quality and patient outcomes.